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NPI Code Detail

MEDICARE: ALICE JEAN MULLHOLAND OTR/L, CHT

MEDICARE: ALICE JEAN MULLHOLAND OTR/L, CHT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XH1200XHand Occupational Therapist10990NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10119003295OTHERVAVA LICENSE

General Provider Information

NPI Number : 1578505848
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE JEAN MULLHOLAND OTR/L, CHT
Provider Business Mailing Address
First Line : 1991 FORDHAM DR STE 102
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3774
Country : US
Telephone Number : 910-484-4653
Fax Number : 910-483-9256
Provider Business Practice Location Address
First Line : 1991 FORDHAM DR STE 102
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3774
Country : US
Telephone Number : 910-484-4653
Fax Number : 910-483-9256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 07/22/2025

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1457685745 — MR. DAVID JOHANSON DPT
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Practice Fax: 910-483-9256
1114903564 — MARY M. WALSH OTR/L, CHT
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Practice Location Address:
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1083700413 — MATTHEW PAUL CONDO DPT
Practice Location Address:
1991 FORDHAM DR STE 102
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28304-3774
Practice Phone: 910-484-4653
Practice Fax: 910-483-9256

Directions to “ ALICE JEAN MULLHOLAND OTR/L, CHT” Practice Location

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